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Statin reduces the risk of dementia in diabetic patients receiving androgen deprivation therapy for prostate cancer

Prostate Cancer and Prostatic Diseases volume 22, pages 276–283 (2019)Cite this article

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Abstract

Background

Androgen deprivation therapy (ADT) has been reported to increase the risk of dementia. Statin use decreases the risk of dementia. This study is aimed to investigate the association of statin use and dementia in type 2 diabetic (T2DM) patients receiving ADT.

Methods

Using the National Health Insurance Research Database of Taiwan, we conducted a population-based nationwide cohort study of T2DM patients newly diagnosed with prostate cancer (PCa) between 1998 and 2013. To test statin effects on dementia in T2DM patients receiving ADT, cox proportional hazards models with 1:1 propensity score-matched analysis were used. We divided the study subjects into a statin group and a statin-naive group. The primary outcome was dementia.

Results

Of the 9855 selected T2DM patients newly diagnosed with PCa between 1998 and 2013, 5427 patients received ADT for their PCa. After propensity score matching, 1006 statin users and 1006 non-statin users were included in the study cohort, with a mean follow-up period of 3.5 years for the statin group. Among those patients, 179 (8.7%) were newly diagnosed with dementia. A propensity score-matched analysis (hazard ratio = 0.70, 95% confidence interval = 0.52–0.94) demonstrated a significantly decreased risk of subsequent dementia in the statin users with an absolute risk reduction by 1%. A significant decrease in the risk of dementia with increasing statin duration was also demonstrated (P for trend = 0.002).

Conclusions

Statin use in T2DM patients receiving ADT for PCa had decreased risk of dementia, with statin adherence and intensity augmenting this benefit.

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Acknowledgements

This study was supported by the Ministry of Science and Technology Taiwan (Grants No. MOST 104-2320-B-016-012-MY3), the Taoyuan General Hospital, Ministry of Health and Welfare (Grants No. PYT10702), and the Chang Gung Memorial Hospital, Taiwan (grant CGRPG2F0011, CLRPG2C0021, CLRPG2C0022, CLRPG2C0023, CLRPG2C0024, CLRPG2G0081)

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Author notes

  1. These author contributed equally: Jui-Ming Liu, Tien-Hsing Chen

Authors and Affiliations

  1. Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Jui-Ming Liu & Heng-Chang Chuang

  2. Department of Medicine, National Yang-Ming University, Taipei, Taiwan

    Jui-Ming Liu

  3. Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan

    Jui-Ming Liu & Ren-Jun Hsu

  4. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan

    Tien-Hsing Chen

  5. Department of Urology, Chang Gung Memorial Hospital, Keelung, Taiwan

    Chun-Te Wu

  6. Biobank Management Center of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Ren-Jun Hsu

  7. Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Ren-Jun Hsu

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Correspondence to Ren-Jun Hsu.

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Liu, JM., Chen, TH., Chuang, HC. et al. Statin reduces the risk of dementia in diabetic patients receiving androgen deprivation therapy for prostate cancer. Prostate Cancer Prostatic Dis 22, 276–283 (2019). https://doi.org/10.1038/s41391-018-0091-4

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